New and Noteworthy from The New York Times, original article by Sarah Maslin Nir
Fentanyl, a prescription synthetic opioid, is now a black market product sweeping the street drug market. It's not just cheap, but it's extremely lethal and 100 times more powerful than naturally generated opioids.
The rise has coincided with an increasing body count: over 100,000 Americans died from overdoses in the 12-month period ending in April, a new high, according to preliminary data from the US Centers for Disease Control and Prevention. Synthetic opioids like fentanyl were blamed for the bulk of the deaths.
The majority of investigations of overdose deaths in New York City now confirm that fentanyl was involved, including Michael K. Williams' death in his Brooklyn apartment.
It's mixed into party drugs, where it can be consumed unknowingly, as six individuals on Long Island were killed by a single batch of laced cocaine this summer.
While the rising death toll demonstrates the catastrophic effects of fentanyl's spread, it is less understood why the drug has become so popular. And why is it now found in so many illegal products, from fentanyl-laced cocaine and crystal methamphetamines and marijuana, to fentanyl-laced fake prescription tablets colored and stamped to look like a brand-name drug?
Dr. Chinazo O. Cunningham, executive deputy commissioner of the New York City Department of Health and Mental Hygiene, indicated that people who use stimulants like cocaine intermittently have low tolerances for potent synthetic opioids.
According to the Health Department, only 17 of the city's overdose deaths in 2015 had evidence of cocaine and fentanyl, and that number jumped to 183 in 2019, the most recent year for which data is available.
“These are no longer street drugs,” said John Tavolacci, the executive vice president and chief operating officer of Odyssey House, a drug rehabilitation center in New York City. “This is poison.”
Fentanyl is the third wave of an opioid pandemic that began with prescription drugs in the 1990s and progressed to an explosion of heroin use.
Communities are now dealing with a fentanyl onslaught as prescription pain medicines have become expensive on the underground market as pharmaceutical corporations have tightened the grip on them following a slew of legal setbacks for their role in the opioid epidemic. Fentanyl has now become the drug of choice for addicts.
Cartels and small-time manufacturers have flooded the streets with fake pills – fentanyl tablets that look like prescription brands — to profit from the situation. The US Drug Enforcement Administration issued a public safety advisory in September, stating that more than 40% of black-market prescription pills contain fatal levels of fentanyl.
“Like a wolf in sheep’s clothing, these pills are lethal,” Ray Donovan, then the D.E.A’.s special agent in charge of the New York division, said in a statement.
The New York D.E.A. has tripled fentanyl seizures since 2018, while confiscated heroin has dropped by more than half. According to the New York Drug Enforcement Administration, 1,099 kilograms of fentanyl have been taken off the street thus far in 2021, compared to only 434 kilograms of heroin.
Enforcement is on high alert because, according to Ms. Brennan, as fentanyl circulation rises, so do overdose deaths.
According to Ben Westhoff, author of "Fentanyl, Inc. How Rogue Chemists Created the Deadliest Wave of the Opioid Epidemic," fentanyl is mostly manufactured in China, which then transports it or the basic ingredients, known as precursors, to Mexico, where it is finished by cartels. It's commonly available on the "dark web," an untraceable online network, and it's also sent through the mail.
Fentanyl analogues, the approximately 1,000 related compounds that imitate fentanyl's behavior and are frequently substituted to prevent detection, are complicating factors.
China banned all analogues in 2019 in response to pressure from the Trump administration. However, according to Mr. Westhoff, author of "Fentanyl Inc.," the move increased the volume of raw ingredients being shipped in, many of which are legal.
The Biden administration extended a temporary order in September to include all fentanyl analogues in the most serious category of banned substances, known as Schedule 1.
In Suffolk County, Odette R. Hall, the chief medical examiner, is using the new mass spectrometer to dig through deaths, to figure out whether fentanyl or its analogues were to blame — or, she fears, whatever novel drug is coming next.
“Whatever is happening on the street,” Dr. Hall said, “is always going to be a step ahead.”
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NYT Article:
https://www.nytimes.com/2021/11/20/nyregion/fentanyl-opioid-deaths.html